Healthcare Provider Details

I. General information

NPI: 1427152420
Provider Name (Legal Business Name): SHERRY RENE TIMMONS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 12/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

386 DENTAL SCIENCE BLDG S
IOWA CITY IA
52242-1001
US

IV. Provider business mailing address

322 DENTAL SCIENCE BLDG S
IOWA CITY IA
52242-1001
US

V. Phone/Fax

Practice location:
  • Phone: 319-335-9656
  • Fax: 319-335-7351
Mailing address:
  • Phone: 319-335-7440
  • Fax: 319-335-7451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number08376
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: